Dental
DR. John D. Gustafson, D.D.S., PA
DR. John D. Gustafson, D.D.S., PA was paid $415.16 by Medicaid between Oct 2024 and Oct 2024, across 1 billing code. Its largest line is D0120, dental checkup, returning patient — 100% of everything it billed.
33Billing provider infoDR. JOHN D. GUSTAFSON, D.D.S., PA
ARLINGTON, MN 55307
ARLINGTON, MN 55307
33aNPI1760737647assigned 07/17/2012
33bProvider typeDentist
28Total paid$415.16
24GClaims12
24DCodes billed1
24AFirst – last monthOct 2024 – Oct 2024
Compared with peers
Next to other Dentist providers in Minnesota
Rank by total paid#164 of 192
Median peer was paid$9K
This provider vs. median0.0×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2024incomplete | 12 | $415.16 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 100% | 12 | 12 | $415.16 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialGUSTAFSON, JOHN (OWNER)